Deborah’s Blog

In researching the subplots in my newest medical mystery/thriller Silent Survivor, I spent hours reading stories of veterans who had experienced military sexual trauma and college students who had been sexually assaulted.

Of course I was aware that many women in various professions – acting, corporate, government, for example- have experienced sexual harassment and even assault.

But frankly, as a physician myself, I was surprised to find that medicine has yet to have its #MeToo moment.

According to NBC News, a 1995 study found that more than half of all women in academic medicine said they had been sexually harassed.

Two decades later, Dr. Reshma Jagsi, professor of the University of Michigan and director of the school’s Center for Bioethics and Social Sciences in Medicine, did her own survey of top physician/scientists. Hoping for progress, she was disappointed to find that 30% of female doctors still report being the victims of sexual harassment. Only 4% of men reported the same.

DeFilippis in a JAMA oped, stated that “to be a women in medicine, whether in training or in a senior role, includes the unique challenge of facing sexist behavior from patients and even colleagues on a regular basis in an already stressful work environment.”

In a 2018 Medscape survey of 3700 physicians, more than one in four (27%) said they had experienced at least one incident of being sexually harassed within the last three years. Yet only 40% reported any of these incidents. Less than 25% of their reports resulted in any investigation.

“The Medscape report underscores the need to take on the issue of harassment within the medical community and ensure that those who are victimized will be heard,” said Hansa Bhargava, M.D., a pediatrician and Medscape medical editor.

Last year (2017) was the first time that the majority of medical students across the country were female. Still, in terms of practicing doctors, women are still a minority (326,902 female doctors compared with 623,054 male doctors)

Up to now there has been a culture of silence in medicine. Women interviewed said fear of speaking up could cost coveted recommendation letters and negatively influence career progress. Sadly, medical students who experience sexual harassment have the highest rates of suicide.

One resident stated that “keeping quiet about this helps no one.” This is precisely the message I’d hoped to promote in my novel Silent Survivor and one I hope will resonate in my own medical profession.

Today I have been Interviewed by Dan Alatorre, one of the 25 authors who have contributed novels, novella and short stories to a boxed set titled Death and Damages. My contribution is a novel titled Double Illusion. Click here to read the interview for some background about the story and a sneak peak!

Reviewers have praised Silent Survivor as a page-turner thriller that deals with several timely issues – among them college rape. Unlike military sexual assault which is unambiguous in the sense that there is generally no issue about whether the sex is consensual, rape among college students often becomes a “she said, he said.”

In 2014, Federal investigators investigated whether 55 colleges and universities in 27 states and in the District of Columbia illegally handled sexual violence and harassment complaints.

A 2015 academic studyreported that during their freshman year of college 15 percent of women are raped while incapacitated from alcohol or drugs.

That’s one of the debate stoppers about rape on campus as too many people today still consider sex with an unconscious drunk girl part and parcel of the college experience.

As part of research for her 2018 book about sex in college “American Hookup: The New Culture of Sex on Campus,” Lisa Wade visited 24 colleges. She describes an accepted culture dominating college campuses that promotes drugs, excessive alcohol imbibing and sexual hookups – a culture that can make it difficult for some to argue against the narrative of girls “asking for it” and boys not being able to control themselves.

As a former Medical Director of Primary Care at UCLA’s Student Health Service in the 1990’s, I can certainly attest to many students feeling undue pressure to drink and have sex even when they preferred not to – especially those in sororities and fraternities.

I had hoped that times had changed. But if Wade is correct about today’s pervasive hookup culture, there is a greater need than ever to have a national debate about ending it.

For those who tend to see ambiguity in the above “she said, he said” situations, no one should doubt the guilt of a former Stanford University swimmer who carried an unconscious women behind a dumpster and sexually assaulted her. His six-month jail sentence produced appropriate national outrage.Equally outrageous, during the trial the defense still found a way to attack the victim’s character, to exalt the perpetrator’s athletic merits, to spin it as “no big deal”.

According to Wade, in the culture of sex dominating college campuses today, status is what sex is all about and that status gives athletes sexual access. In her column The Conversation in Business Insider in 2017 she stated that “…athletes are more likely than other students on campus to identify with hyper-masculinity and to accept ‘rape myths’ to justify sexual assaults”.

Again if this is true and my experience on one college campus validates her assertion, then the national conversation we need to have about drinking, drugs and the hookup culture must include discussion about the facts around perceived social status related to having sex with athletes.

In Silent Survivor, I wanted to create subplot that would encourage readers –especially those in book clubs – to open up a dialogue about consent and rape on college campuses, to change attitudes with the hope that in 2018 and going forward “she said, he said” will no longer be ambiguous.

Too often a taboo subject, military sexual assaultis integral to the story in Silent Survivor.

Before I began plotting this novel, I created my protagonist Mackenzie (known as Mac to her friends) Dodd. I knew I wanted Mac to be a strong woman, but I also wanted her to be a veteran of the Middle East wars so she could investigate the mystery of the illness fellow vets were experiencing on returning stateside. Thus, Mac became an ex-Army nurse who’d spent time in Iraq.

That’s when I started reading about the experiences of women in today’s military. The more I searched, the more articles I found focusing on military sexual trauma (MST), a situation that unfortunately has taken decades to gain public attention.

Today, Veterans Affairs (VA) defines MST as “psychological trauma, which in the judgment of a VA mental health professional, has resulted from a physical assault of a sexual nature, battery of a sexual nature, or sexual harassment which occurred while the Veteran was serving on active duty.” The VA further defines sexual harassment as “repeated, unsolicited verbal or physical contact of a sexual nature which is threatening in nature”

At least nine separate bills (like the one proposed by my fictitious Congresswoman Cooper) have been introduced in Congress by a bipartisan mix of senators and representatives, proposing a range of fixes.

According to a report filed by the Department of Defense’s Sexual Assault Prevention and Response Office in March, 2010, there were 3,158 sexual assault complaints in that year alone. The Pentagon acknowledged that given the underreporting of MSTs, that number probably accounts for about 13.5 percent of the estimated 19,000 incidents that occurred that year. Only 20 percent of reported cases went to trial, which represent half the rate of the civilian justice system.

In February, 2011, 25 female and 3 male vets who were sexually assaulted while wearing the uniform filed an abuse lawsuit (Cioca v. Rumsfeld) alleging that Robert Gates and his predecessor, Donald Rumsfeld, had failed to curtail widespread rape in the military. However, within a month, the judge, dismissed the case.

A 2012 study of a subset of 213,803 Iraq and Afghanistan veterans of veterans diagnosed with PTSD from April 1, 2002, to October 1, 2008, found that 31 percent of the women and 1percent of the men screened positively for MST.

Contributing to PTSD suffered by survivors of military sexual assaults is the harassment of victims who make an official complaint. Ninety percent of them are eventually involuntarily discharged. Today women in the military are still more likely to be raped by fellow soldiers than they are to be killed in combat.

So, these are the factual stats that led me to develop Mac’s character – an Iraq vet who’d been raped by her commander and who’d been given an honorable discharge in exchange for her silence about the assault.

Committed to silence, Mac starts a blog as an anonymous Silent Survivor. She invites fellow vets to share their stories. Many of the posts that I included in the book are based on actual stories I’d read about on the web. Real life veterans who’d been raped or sexually harassed and no one was ever held accountable.

I dedicated this book to all the survivors who understand that only by exposing the truth can secrets lose their power.

On July 12, 2017, Republican representative Jaime Herrera Beutler and Democratic representative Niki Tsongas introduced HR 3209, Protecting Military Honor Act, in the House of Representatives. Senator Richard Blumenthal introduced the bill in the Senate.

This bipartisan proposed law would make it harder to discharge traumatized sexual assault survivors for “personality disorder” or other mental health conditions that might not qualify them for disability benefits and block them from health care covered by the VA. It would expand current protections intended to prevent combat veterans from being erroneously discharged for conditions resulting from trauma to include sexual assault victims – who, studies show, are even more likely than combat veterans to have PTSD.

This bill would also strengthen legal protections against retaliation for reporting illegal conduct, including sexual assault and sexual harassment.

Until three years ago, the Military Whistleblower Protection Act had protected not a single sexual assault survivor. Yet, this has been their only recourse if they believe they experienced reprisals after reporting their assault. The Protecting Military Honor Act would bring the Military Whistleblower Protection Act standards in line with best practices and standards for civilians, thereby removing barriers to reporting sexual assault.

Apparently this bill was referred to the subcommittee on Military Personnel where it still sits. According to one article I found online the prognosis for this bill being enacted is only three percent.

I hope you all agree that this is unacceptable.

Bottom line: My hope is that perhaps with pressure from readers of Silent Survivor, Congress will eventually pass a law that will protect these women and men.

Silent Survivor may be fiction, but the main plot as well as the various subplots are based on very real contemporary issues like PTSD in the military.

Did you know that up until 1980, vets who served in our two World Wars, Korea and even Vietnam were said to suffer from “shell shock” – a condition that received very little attention.

It too 4 decades before the condition Post Traumatic Stress Disorder was introduced into the Diagnostic and Statistical Manual of Mental Disorders (DSM). PTSD is often accompanied by depression, substance abuse, or other anxiety disorders. Typical symptoms include hyper-vigilance, emotional numbness and recurring flashbacks.

According to experts, as many as 30 percent of veterans of the Iraq and Afghanistan wars have PTSD. Many are reluctant to talk about it. Secrecy and shame have resulted in a virtual epidemic of suicides attributed to the disorder. Hard to believe, but since 2001, more US service members have taken their own lives than have died in combat!!

In 2012, a US Office of Veterans Affairs (VA) study found that on average, 22 US military vets commit suicide everyday. Incredible!!

The Veterans’ Crisis Center in Canandaigua, New York is the only call center in the US serving vets in crisis. Employing 250 responders, 25 percent of whom are veterans themselves, the center receives over 22,000 calls each month.

Because there is such a great need to help the brave men and women who volunteered to fight for our country, every dollar from sales of Silent Survivor will be donated to charities that help veterans with PTSD and their families.

Sara Holoubek, CEO of Luminary Labs is a true creative leader. As she writes in FastCompany, rather than accept “conventional wisdom” about the negatives effects her pregnancy would have on her organization, she saw an opportunity to decrease those supposed risks, developing strategies that only made the company stronger. Bravo!

Once again, it’s June 4th and another anniversary of the Tiananmen massacre of 1989.

Hard to believe 24 years have passed since hundreds, if not thousands, of unarmed protesters were shot in the square and with those years, so much change.

Anyone who visits China today will see cities like Beijing, Shanghai and Guangzhou that are more modern than most American cities where sophisticated residents dress in the most fashionable styles, drive brand new cars and carry the most up-to-date electronic devices.

While the economy has embraced quasi-capitalism with a vengeance, the politics of one party rule has remained. Twenty-four years after a brief promise of democratic reform, the leaders’ aim to squelch any mass political protest is unwavering. Even though some of the new leaders installed in November had, as young men, expressed sympathy with the short-lived student democracy movement of 1989, no one really expects any announcement of regret about the massacre or overruling of the official verdict that the protests were a counterrevolutionary rebellion that had to be crushed.

In 2012, Ann Marie Slaughter’s piece in The Atlantic titled “Why Women Still Can’t Have it All” instantly went viral with over 2 million online readers and got everybody talking. Last month was Women’s History Month celebrating the 50 year anniversary of Betty Friedan’s “Feminine Mystique” and the rolling out of Sheryl Sandberg’s new book urging women to “lean in”, along with the controversy over Marissa Mayer’s, CEO of Yahoo, memo about not allowing anymore telecommuting at her company.

All this has brought renewed attention to the issue of women as leaders- not only from mainstream media- but also on social networking sites like Twitter, Facebook and Linkedin.

In Deborah Shlian’s new book “Lessons Learned: Stories from Women in Medical Management” 24 exceptional women physicians who are leaders in healthcare share their personal stories including the obstacles they have faced in their career journeys including the challenge of balancing their work and personal lives.

Forbes has not only given the book a great review, but George Anders, the reviewer posted this on Facebook:

“Here’s a book pairing that intrigues me. For a sense of what women can achieve at the very highest levels of business, and how to get there, there’s nothing likeSheryl Sandberg’s acclaimed new book, “Lean In.” For a grass-roots perspective of all the opportunities and juggling involved with those first few steps up the management ladder, try this intriguing new book about female doctors, edited by Deborah Shlian. I just finished it and give it a thumbs-up on Forbes.com .”

So here’s hoping you will take the reviewer’s suggestion and read both books! Here’s a link to Amazon. “Lessons Learned” is available in print and as an eBook.

Today (Sunday, February 10, 2013) is the first day of this important annual celebration marking the start of the new year according to the Chinese lunisolar calendar. The holiday is also known as the Spring Festival because in pre-modern times it was the seasonal sign that farmers in China had to start sowing their fields.

The date usually falls in the months of January or February and each new year is represented by one of the twelve creatures of the Chinese Zodiac. 2013 is the year of the Snake, also called the Junior Dragon. According to ancient Chinese wisdom, a Snake in the house is a good omen because it means that the family will not starve.

People born under the sign of the snake (1929, 1941, 1953, 1965, 1977, 1989, 2001, 2013) share certain personality characteristics. They are said to be cunning, thoughtful and wise. They are also great mediators and good at doing business.

The characteristics of the Snake are tempered by one of the 5 Chinese elements of Metal, Water, Wood, Fire, and Earth overlaying a 5-year cycle of characteristics on the original 12-year cycle.

In 2013, that element is water. Water Snakes are influential and insightful. They are good at managing others, are motivated, intellectual, determined and resolute about being successful at whatever they do. Although they are affectionate with family and friends, they tend to hide this side of their personality from colleagues or business partners.

More than a billion people around the world will be ushering in the Year of the Snake with festivities that last for a few weeks after new year’s day.

Not only is holiday celebrated in China, but also in countries and territories with significant Chinese populations, including Taiwan, Macau, Mauritius, Philippines,Thailand, Indonesia, Malaysia, Singapore, as well as in Chinatowns everywhere from Canada to the US to Africa to Australia.

Within China, regional customs and traditions concerning the celebration of the Chinese new year vary widely. People will pour out their money to buy presents, decoration, material, food, and clothing. It is also traditional for every family to thoroughly cleanse the house, in order to sweep away any ill-fortune and to make way for good incoming luck. Windows and doors will be decorated with red color paper cutouts and Chinese poetry about good fortune, happiness, wealth and longevity.

Typically on New Year’s eve, Chinese families gather for the annual reunion dinner which is a big feast. Dishes include pork, duck, chicken, sweet delicacies as well as fish. The tradition is that the fish is not finished during the meal, so that it can be stored overnight – a belief that the years will be blessed and profitable. Families end the night with firecrackers. Early the next morning, children greet their parents by wishing them a healthy and happy new year, and receive money in red paper envelopes. The Chinese New Year tradition is to reconcile, forget all grudges and sincerely wish peace and happiness for everyone.

Celebrations traditionally run from Chinese New Year’s Day itself to the Lantern Festival on the 15th day of the first month of the Chinese calendar.